Haitian Earthquake Relief: Disaster Response Aboard the USNS Comfort

2012 ◽  
Vol 6 (4) ◽  
pp. 370-377 ◽  
Author(s):  
Ryan M. Walk ◽  
Timothy F. Donahue ◽  
Zsolt Stockinger ◽  
M. Margaret Knudson ◽  
Miguel Cubano ◽  
...  
Keyword(s):  
Disaster Response ◽  
Average Length ◽  
Mass Casualty ◽  
Unique Identifier ◽  
Average Length Of Stay ◽  
Us Military ◽  
The Us ◽  
Patient Database ◽  
Medical Teams ◽  
Relief Efforts

ABSTRACTObjective: The Haitian earthquake of January 12, 2010, was a disaster essentially unprecedented in the Western Hemisphere's recorded history. The USNS Comfort departed from Baltimore, Maryland, within 72 hours of the earthquake and arrived in Port-au-Prince harbor on January 19. During the subsequent 40 days, the ship provided one of the largest relief efforts in the US Navy's history.Methods: The data analyzed included all patients evaluated and treated by the USNS Comfort between January 19 and February 27, 2010. A medical chart with a unique identifier was created for each patient on admission. A patient database was created from these records and used for this analysis.Results: A total of 872 patients and 185 patient escorts were processed aboard the ship. Ages ranged from younger than 1 day to 89 years: 635 were adults and 237 were children. Of those admitted, 817 of the patients were admitted for longer than 24 hours; the average length of stay was 8.0 days. The need for surgery was substantial: 454 patients went to the operating room (OR) 843 times for 927 cumulative procedures. A total of 58 patients underwent amputations.Conclusions: Haiti was almost completely reliant on foreign medical teams for trauma care. Analysis of the data illustrates the challenges of triage and treatment in a humanitarian mass-casualty response. The remarkable coordination and cooperation among the Haitian Ministry of Health, nongovernmental humanitarian aid organizations, and the US military highlighted the responders' respective capabilities and demonstrated the importance of collaboration in future disaster response efforts.(Disaster Med Public Health Preparedness. 2012;6:370–377)

scholarly journals Lessons from the Brussels Terrorist Attack

2019 ◽  
Vol 34 (s1) ◽  
pp. s91-s92
Author(s):  
Andreas Möhler
Keyword(s):  
Disaster Response ◽  
Terrorist Attack ◽  
Damage Control ◽  
Mass Casualty ◽  
Emergency Plan ◽  
War Injuries ◽  
Burn Care ◽  
Medical Response ◽  
Key Factor ◽  
Medical Teams

Introduction:On March 22, 2016, the capital of Europe was hit by two terrorist attacks. As terrorism becomes more and more violent, it is critical to learn and share experiences in order to enhance effectiveness in saving lives.Methods:A field perspective and experience feedback from the Emergency Medical Response.Results:The first attack hit the departure hall of the airport, which, due to its strategic role, relies upon a dedicated emergency plan. However, it focuses on airplane crashes and not on explosions in a crowded terminal. The second attack hit the subway at rush hour. An attack in such a confined environment is particularly challenging for the rescue teams, as injuries are worsened, access hindered, and exits numerous.Eleven medical teams were sent in order to perform triage and provide vital care. The medical response was organized by two disaster response teams. Advanced Medical Posts were set up and the mass casualty plans of all hospitals were activated. Managing war injuries for civilian teams was challenging. On-site care consisted essentially in prehospital damage control and burn care in order to ensure rapid evacuations for haemostatic surgery. 313 victims were dispatched to thirty hospitals. Another challenge was safety. Several threats were apparent and explosives were found on both sites. Lessons from Paris had prompted a review of our multiple sites Emergency Plan. One single way of communication was used and the evacuations were managed centrally. Finally, the key factor that helped limit the number of casualties was the acquaintanceship between emergency workers and non-medical teams built during exercises, allowing them to adapt and blend in as one team.Discussion:Lessons from previous attacks were crucial to improve our management of the medical response. These should be shared around, as another attack may always occur anywhere and at any time.

scholarly journals (P1-9) Multinational Disaster Response Exercise: Critical Look and Lessons Learned

2011 ◽  
Vol 26 (S1) ◽  
pp. s101-s101
Author(s):  
T. Norii ◽  
Y. Terasaka ◽  
M. Miura ◽  
T. Nishinaka ◽  
R. Lueken ◽  
...  
Keyword(s):  
Disaster Response ◽  
Lessons Learned ◽  
Medical Team ◽  
Team Members ◽  
Disaster Assistance ◽  
Us Military ◽  
Military Members ◽  
Response Team ◽  
Medical Teams ◽  
National Disaster

IntroductionInternational collaboration for disaster response is an increasing phenomenon. Japan-United States joint field exercises have been conducted annually since 2004, triggered by an incident in which a US helicopter crashed into a university campus in Okinawa, Japan. The fifth Japan-US disaster field exercise was conducted testing the disaster response of the Okinawa government and US military.MethodsThe simulated exercise involved a US Navy aircraft that crashed into a city center in Okinawa, Japan. There were 16 simulated casualties that included US military members and Japanese citizens. The participants in this exercise were US military members, including the Disaster Assistance Response Team (DART) and local rescue and medical teams including the Okinawa Disaster Medical Assistance Team (DMAT). Data were gathered from the joint debriefing session held by both medical teams. Furthermore, interviews with team leaders from both nations were conducted and feedback obtained.ResultsLack of communication and inaccurate communication remained the root of most problems encountered. There were several miscommunications at the scene due to the language barrier and ignorance of different medical teams' capability and method of practice. Due to the unclear signage of the initial triage zone, another triage zone was developed later by a second medical team. Confusion regarding gathering information and order of transport also was witnessed. The capabilities of team members were not well known between teams, resulting in inappropriate expectations and difficulty in effective cooperation.ConclusionsUnderstanding the systems and backgrounds of each medical team is essential. Signs or symbols of key elements including triage areas should be clear, universal, and multilingual. Communication remains the Achilles' heel of multi-national disaster response activities.

Emergency department presentation with colorectal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15094-e15094
Author(s):  
Yasmin A. Zerhouni ◽  
Nelya Melnitchouk ◽  
Eric Schneider ◽  
Aparajita Singh
Keyword(s):  
Colorectal Cancer ◽  
Emergency Department ◽  
Average Length ◽  
Primary Diagnosis ◽  
Surgical Patients ◽  
Average Length Of Stay ◽  
The Us ◽  
Ed Visits ◽  
Index Hospital ◽  
Emergent Surgery

e15094 Background: Despite screening protocols shown to reduce mortality, colorectal cancer (CRC) remains the 2nd leading cause of cancer death in the US. CRC patients who have emergent surgery have worse outcomes than those treated electively. We examined presentation and index hospital outcomes for emergency department (ED) patients with a primary diagnosis of CRC. Methods: The 2013 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried and all patients with a primary ICD-9-CM diagnosis of CRC were identified. Descriptive analyses were weighted to the level of the US population. Results: Among 134,869,015 ED visits, approximately 44,717 patients received a primary diagnosis of CRC. Patients with CRC were older (68 vs. 40 years, p < 0.001) and more likely to be male (50.4% vs. 44.3%, p < 0.001) than those presenting for other reasons. Among CRC patients, 88.6% were older than 50 years with males younger than females (66 vs. 70y, p < 0.001) and 90.4% were insured. 88.6% were admitted of whom 44% underwent oncologic resection. Females were more likely to undergo resection (47% vs.42%, p = < 0.001) and to be older at time of surgery (71 vs. 68, p = < 0.001). Average length of stay was 12.5 days for surgical vs. 6.6 days for non-surgical patients (p < 0.001). After admission, 68.0% of those admitted vs. 64.7% of patients who had surgery were discharged home. 6.9% of admitted CRC patients and 4.7% of surgical patients died in-hospital. Average total charges were $124,846 for patients undergoing resection vs. $53,542 for inpatients who did not undergo surgery (p < 0.001). Conclusions: Most patients presenting to the ED for CRC are admitted and many require surgical intervention. Because nearly 90% were 50 or older and insured, further research is warranted to determine if increased screening among eligible patients might reduce the numbers of ED presentations and emergent surgical procedures for CRC.

Abstract 23: Trends in Kawasaki Disease Incidence - 2004-2014

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Sara K Sexson Tejtel ◽  
Andrea A Ramirez ◽  
Amy Liou ◽  
Thomas Seery ◽  
Debra Canter ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Average Length ◽  
Disease Incidence ◽  
Steady Increase ◽  
Patients Âgés ◽  
The Past ◽  
Average Length Of Stay ◽  
Number Of Patients ◽  
The Us ◽  
Acquired Heart Disease

Background: Kawasaki disease is the leading cause of acquired heart disease in children in the US. While it remains a rare disease, the purpose of this study is to evaluate the incidence of KD Methods: To evaluate our hypothesis we used the Pediatric Health Information Systems (PHIS), 2004-2013, including all discharges at 44 of the largest freestanding children’s hospitals in the US. Results: Between 2004-2013, there were 16,417 hospitalizations for KD, 10,388 (61%) were male. The race of patients admitted with KD showed 5276 (31%) Caucasian, 2370 (14%) African American, 1586 (9.3%) Other, and 941 (5.5%) Asian. The average length of stay 3.9 days. The number of patients with KD increased annually for the past decade, Figure 1. The largest proportion of the increase was from those children between 1 and 5 years of age, Figure 2. Most children were only hospitalized once (14,231, 84%) however some children required subsequent hospitalization (1,291,8%). Conclusions: There has been a steady increase in the number of admissions per year for Kawasaki disease predominately for those patients ages 1-5 years.

Uneasy Partners: NGOs and the US Military in Complex Humanitarian Emergencies.

1996 ◽  
Author(s):  
Guy C. Swan ◽  
Beardsworth III ◽  
Kikla Richard R. ◽  
Shutler Richard V. ◽  
Philip
Keyword(s):  
Humanitarian Emergencies ◽  
Us Military ◽  
The Us ◽  
Complex Humanitarian Emergencies
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